Every initial, revalidation, change of ownership, new practice location and new owner application is screened at the risk level CMS assigns to the provider or supplier type: limited (physicians and nonphysician practitioners, ambulatory surgical centers, end-stage renal disease facilities, FQHCs, hospitals, rural health clinics, pharmacies and others) with verification of Federal and State requirements, licence verification across States and pre- and post-enrollment database checks; moderate (ambulance suppliers, community mental health centers, CORFs, independent laboratories, IDTFs, physical therapists, portable x-ray suppliers, continuously certified opioid treatment programs and revalidating HHAs, hospices, SNFs, DMEPOS and MDPP suppliers that were fingerprinted at initial enrollment) adding an onsite visit; and high (newly enrolling HHAs, DMEPOS suppliers, MDPP suppliers, SNFs, hospices and uncertified opioid treatment programs, and those types on a change of ownership or new owner) adding submission of fingerprints by every individual with a 5 percent or greater direct or indirect ownership interest for an FBI criminal history check. CMS raises the level to high after a payment suspension within 10 years, an OIG exclusion, a revocation within 10 years when re-enrolling, Medicaid termination, exclusion from any Federal health care program, any final adverse action within 10 years, or enrollment within 6 months after a moratorium is lifted, and the adjustment applies to every enrollment under the same legal name and TIN. Fingerprints must be submitted with the application or within 30 days of a contractor request, failing which the application is denied or the enrollment revoked.
The graph holds this control, the 0 it maps to, and the evidence behind each claim, over MCP and REST.